Format

Send to

Choose Destination
Occup Med (Lond). 2015 Aug;65(6):444-50. doi: 10.1093/occmed/kqv073. Epub 2015 Jun 12.

Outbreak of autoimmune disease in silicosis linked to artificial stone.

Author information

1
Pulmonary Institute, Rabin Medical Centre, Beilinson Campus, Petah Tikva 49100, Israel, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
2
Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-0924, USA.
3
Pathology Institute, Rabin Medical Centre, Beilinson Campus, Petah Tikva 49100, Israel, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
4
Institute of Pulmonary and Allergic Diseases, National Service for Interstitial Lung Diseases, Tel Aviv Sourasky Medical Centre, Tel Aviv 6423906, Israel.
5
Pulmonary Institute, Rabin Medical Centre, Beilinson Campus, Petah Tikva 49100, Israel, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, kremerm@clalit.org.il.

Abstract

BACKGROUND:

There is a well-established association between inhalational exposure to silica and autoimmune disease. We recently observed an outbreak of silica-related autoimmune disease among synthetic stone construction workers with silicosis referred for lung transplantation assessment.

AIMS:

To characterize the rheumatologic complications in silicosis within these highly exposed, clinically well-characterized patients.

METHODS:

We systematically reviewed data from all cases of silicosis due to synthetic stone dust referred to our pulmonary institute for lung transplant assessment, which represents the national centre for all such referrals. In addition to silicosis-specific data, we extracted data relevant to the clinical and serological manifestations of autoimmune diseases present in these patients.

RESULTS:

Of 40 patients in our advanced silicosis national data, we identified nine (23%) with findings consistent with various autoimmune diseases. Among these nine, three also had findings consistent with pulmonary alveolar proteinosis. Based on an expected autoimmune disease prevalence of 3% (based on the upper-end estimate for this group of diseases in European international data), the proportion of disease in our group represents a >7-fold excess (prevalence ratio 7.5; 99% confidence interval 2.6-16.7).

CONCLUSIONS:

These cases underscore the strong link between silicosis and multiple distinct syndromes of autoimmune diseases. Vigilance is warranted for the recognition of autoimmune complications in persons with known silicosis; so too is consideration of the occupational exposure history in persons presenting with manifestations of autoimmune disease.

KEYWORDS:

Autoimmune disease; pulmonary alveolar proteinosis; silicosis.

PMID:
26070814
DOI:
10.1093/occmed/kqv073
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center